Organization
MARYVILLE NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN PARRY (ADMINISTRATOR)
(503) 643-8626
Entity
Organization
Contact information
Practice address
14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
(503) 643-8626
(503) 520-1435
Mailing address
14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
(503) 643-8626
(503) 520-1435
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
OR
313M00000X
Nursing Facility/Intermediate Care Facility
—
OR
314000000X
Skilled Nursing Facility
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806745
—
OR
Enumeration date
07/07/2005
Last updated
09/11/2025
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